What if the coverage was not active that day?

Not every denial is about the care you gave. Some are simpler, and sneakier: the insurance was just not active that day.

The code to watch for is CO-27, expenses after coverage terminated. The payer is saying the patient was not active on the date of service. The care was fine. The coverage was the problem.

So before arguing about the visit, ask the real question: was the coverage even active?

1. Open the patient and look at the insurance on file.
2. Check it with the payer, so you are working from a fresh answer rather than an old card.
3. If you come up short, go looking. Click Find insurance for this patient, and the system searches the payers for any active coverage on record. It shows the cost and asks before it runs. See What if a patient has no insurance card?.

Often it finds active coverage the office never knew about, and files it straight onto the patient, effective and billable. That small search fee is the price of finding money you would otherwise write off.

Then fix the claim and send it again as a corrected claim. It goes out as a new attempt and the whole history stays, so you can always see the first try and the fix.